Kornimate/medical-research-clean huggingface dataset:
diagnostic performance of point of care ultrasound to identify intestinal obstruction

Conditions: Bowel Obstruction

Summary: as reported in previous studies, point-of-care ultrasound (pocus) has good performance for the diagnosis of bowel obstruction even when compared with ct. this inexpensive, radiation-free tool is available in a majority of ed. it is performed at the patient's bedside with immediate results. the learning curve allows emergency physicians (ep) to perform this exam after a relative brief training period. the investigators aim to investigate the ability of pocus performed before ct to exclude the diagnosis of bowel obstruction in patients admitted for abdominal pain.

bowel obstruction (bo) is frequently suspected in the emergency department (ed). computed tomography (ct) is commonly used to diagnose this disease. however, ct is not always available in real-time, requires technician times, is associated with increased cost and exposes patients to radiations. the researchers will investigate the diagnosis performances of pocus for the diagnosis of bo with comparison with ct which will be considered as the gold standard. the wain objective will be the ability to exclude the diagnosis of bo, the main criteria being the negative predictive value. the secondary objectives will be the diagnosis performances (sensitivity, specificity, positive predictive value), duration and difficulty of pocus

Eligibility criteria:
inclusion criteria : * adult patients * abdominal pain * suspected bowel obstruction exclusion criteria : - documented end-of-life precluding ct realization

Keywords: bowel obstruction computed tomography ultrasound
chemotherapy of elderly patients with non-small-cell lung cancer (nsclc)

Conditions: NSCLC

Summary: the last asco recommendations in 2003 for the treatment of a cbnpc of stage iiib/iv of elderly people, are to manage a monochemotherapy. paclitaxel in association with carboplatin is feasible in elderly patients and the retrospective analysis of two studies of the comparing swog, one this association with that of cisplatine and vinorelbine and the other cisplatine only with cisplatine and vinorelbine, showed among 117 the 70 years old patients and more, the absence of significant difference of survival and toxicity compared to the younger patients. the study recently published of lilenbaum and al shows that among patients with bad ps, association carboplatine and paclitaxel do better than the paclitaxel only. the paclitaxel managed in weekly form is likely of a better activity by exposing the cancerous cells in a repeated way with shorter intervals without allowing the emergence of resistant clones and by allowing an increase in the intensity of amount. this mode of administration appeared at the same time effective and tolerated very well among patients of more than 70 years. the weekly association of carboplatin and paclitaxel was tested in phase ii and showed a rate of response of 14% and one survival 1 year from 31% a randomized test (not dedicated to the old person) of phase ii to 3 arms was led by belani et al.. the best combination of carboplatine + paclitaxel weekly proved to be that associating paclitaxel 100mg/m² 3 weeks out of 4 and carboplatine auc 6 in j1 with j1 = j29. a test of phase ii dedicated the 70 years old to patients and more was carried out in france taking again this association carboplatine (auc 6) every 4 weeks and paclitaxel weekly (90 mg/m² j1, j8 and j15). this test having included 51 patients highlighted a median of 10,42 months survival (ic 95%: 7,29-17,05)

it thus seemed to us justified to compare a standard arm, the vinorelbine or the gemcitabine (with the choice of the center) in monotherapy with an experimental arm, association carboplatine + paclitaxel. to avoid skewing the results by the introduction of a second line to the choice of the investigator, we chose to force it. it is thus the erlotinib which in a recent test presented by the ncic at the asco 2004 proved its effectiveness in second or third line at the same time in term of response but more especially survival compared to the purely palliative care.

Eligibility criteria:
inclusion criteria: * pathologically / cytologically proven nsclc stage iiib or iv * age \>= 70 years old and \< 90 years old

Keywords: 2-years survival
relative bioavailability of a single dose of bi 44370 tablet during and between migraine attacks

Conditions: Migraine Disorders

Summary: the general aim is to evaluate the relative oral bioavailability of bi 44370 ta tablets during and between migraine attacks as well as safety, tolerability and pharmacokinetic


Eligibility criteria:
inclusion criteria: * adult male and female migraine patients (age 18 to 65 years) with or without aura, diagnosed according to ihs criteria. * established migraine diagnosis for \>= 1 year. * age at migraine onset \<= 50 years. * well documented (for \>= 3 months) retrospective history of migraine with headache of moderate to severe intensity and with an attack duration of at least 6 hours and migraine frequency of 2-8 times / month * other forms of headache are permitted if they on average occur on not more than 10 days / month and if the patient is able to differentiate migraine headache from other forms of headache. * patient has provided written informed consent in accordance with ich-gcp and local legislation. * patient is in general good health based om screening assessment exclusion criteria: * women of child-bearing potential without an adequate method of contraception * any woman of child-bearing potential not having a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline * breastfeeding women * males not willing to use adequate contraception (condom use plus another form of contraception e.g. spermicide, oral contraceptive taken by female partner, sterilization, iud \[intrauterine device\]) during the whole study period from the time of the first intake of study drug until three months after the last intake. * history of hemiplegic, ophthalmoplegic, or basilar migraine or cluster headache. * history of treatment resistant migraine attacks, defined as a lack of response to a range of commonly used acute anti-migraine compounds. * history of , clinical evidence for, or screening/baseline findings suggestive of significant medical disorders (e.g. cardiovascular, peripheral vascular, hepatic, respiratory, haematological, renal, gastrointestinal, immunological, metabolic, hormonal, neurological or psychiatric disorders) * smokers ... (cont.)
renal perfusion, filtration and oxygenation after liver transplantation -effects of av postoperative blood pressure

Conditions: Acute Kidney Injury; Liver Failure

Summary: comparing the effects of map 60, 75 and 90 mmhg, respectively, on renal blood flow, glomerular filtration rate and renal oxygen demand in patients with terminal liver failure directly after liver transplantation.

patients with terminal liver failure are at risk to develop postoperative acute kidney injury (aki) after liver transplantation. this is associated with augmented morbidity (crrt/hd), and mortality. hypotension perioperatively is a risk factor for the development of postoperative aki. in the investigators' study, the researchers aim to investigate the importance of the level of mean arterial pressure (map) on functional renal parameters directly after liver transplantation. 12 patients will be included after given informed and written consent. directly after the operation, the patients stay sedated and ventilated, have reached normovolaemia and are in need of vasopressor for adequate blood pressure. map is varied using the vasopressor norepinephrine. central hemodynamics will be measured using arterial catheter, picco and a central vein catheter. renal data measures (rbf (renal blood flow), rpf (renal plasma flow), ff (filtration fraction), gfr (glomerular filtration rate), rvr (renal vascular resistance), arterial-renal vein oxygen content difference, rvo2 (renal oxygen consumption), and ro2extr (renal oxygen extraction)), are conducted via a renal vein thermodilution catheter: a 8-fr catheter is introduced into the left or right renal vein, via the right femoral vein under fluoroscopic guidance, position being confirmed by venography using ultra-low doses of iohexol. after the collection of blood and urine blanks, an intravenous priming dose of chromium ethylenediaminetetraacetic acid (51cr-edta) is given, followed by an infusion at a constant rate, individualized to bsa and preoperative serum creatinine. serum 51cr-edta activity from arterial and renal vein blood is measured using a well counter. ff is measured as extraction of cr-edta. after one hour and two control measurements and urine/blood sampling on baseline map 75 mmhg, the investigators will randomise to continue to map 90 mmhg or 60 mmhg reached by altering the infusion rate of norepinephrine. measurements, blood sampling and urine collection according to the above description, are performed after 30 min at each level, finishing at 75 mmhg with two control measurements with 30 mins in between.

Eligibility criteria:
inclusion criteria: * uncomplicated liver transplantation * age over 18 years * given informed consent preoperatively exclusion criteria: * veno-venous bypass intraoperatively * uncontrolled postoperative bleeding * circulatory stability without need for vasopressor treatment * pronounced circulatory or respiratory instability

Keywords: acute kidney injury liver transplantation postoperative care glomerular filtration rate renal blood flow vasopressor norepinephrine
docetaxel followed by doxorubicin plus cyclophosphamide for node positive or high-risk primary breast cancer

Conditions: Breast Cancer

Summary: this protocol will evaluate the feasibility and toxicity of dose-dense docetaxel followed by doxorubicin and cyclophosphamide with support given as adjuvant or neoadjuvant treatment of women with node positive and high risk breast cancer

upon determination of eligibility, patients will receive: neoadjuvant docetaxel + doxorubicin + cyclophosphamide + surgery adjuvant patients will enter the study after surgery and receive docetaxel+ doxorubicin + cyclophosphamide. patients treated with lumpectomy will undergo postoperative radiation therapy after completion of chemotherapy. patients with positive estrogen and/or progesterone receptors will begin anti-estrogen therapy after the last course of chemotherapy.

Eligibility criteria:
inclusion criteria: to be included in this study, you must meet the following criteria: * histologically proven breast cancer * females, age greater than 18 years * ability to perform activites of daily living with minimal assistance * normal cardiac function * adequate bone marrow, liver and kidney * signed informed consent prior to beginning specific protocol procedures exclusion criteria: you cannot participate in this study if any of the following apply to you: * prior systemic anticancer therapy for breast cancer * prior anthracycline or taxane based chemotherapy for any malignancy * pregnant or breast-feeding women. * pre-existing moderate to severe motor or sensory neurotoxicity * other serious illness or medical condition please note: there are additional inclusion/exclusion criteria. the study center will determine if you meet all of the criteria. if you do not qualify for the trial, study personnel will explain the reasons. if you do qualify, study personnel will explain the trial in detail and answer any questions you may have.
docetaxel in non small cell lung cancer (nsclc)

Conditions: Carcinoma, Squamous Cell

Summary: primary objective: • to assess the response rate to induction therapy with docetaxel/cddp. secondary objectives: to assess * resectability after induction therapy * time to progression * overall survival * safety profile * quality of life


Eligibility criteria:
inclusion criteria: 1. histology and staging of the disease * histologically or cytologically confirmed nsclc; histology may include: large cell, squamous cell or adenocarcinoma but no sclc * resectable or unresectable nsclc stage ii (t1-2 n1, t3 n0) or stage iiia (t1-2 n2 or t3 n1-2) or stage iiib (t1-3 n3 or t4 n0-3) * measurable disease (bidimensionally or unidimensionally according to who criteria) 2. general conditions * karnofsky status \> 70, if age \> 70 years → ps \> 70 * adequate hematological function (hb \> 10 g/dl, anc \> 2.0 x 109/l, platelets \> 100 x 109/l) * adequate renal and hepatic functions: total bilirubin \ 60 ml/min, asat and alat \< 2.5 x unl, alkaline phosphatase \< 5 x unl. exclusion criteria: 1. diagnosis * evidence of brain metastases or other distant metastasis equivalent to stage iv disease * history of prior malignancies, except for curatively treated non-melanoma skin cancer or in situ carcinoma of the cervix or other curatively treated cancer with no evidence of disease for at least five years * other serious concomitant illness or medical condition: * congestive heart failure or angina pectoris, except if medically controlled, history of myocardial infarction within 1 year from study entry, uncontrolled hypertension or arrhythmia * history of significant neurologic or psychiatric disorders, including dementia or seizure * active infection requiring i.v. antibiotics * active ulcer, unstable diabetes mellitus or other contraindications to corticotherapy * hepatic function abnormality: asat and/or alat \> 1.5 x unl associated with alkaline phosphatase \> 2.5 x unl * current peripheral neuropathy who grade \> 2 2. prior or concurrent therapy * prior chemotherapy or immunotherapy for nsclc, including neoadjuvant or adjuvant treatment * prior surgery or radiotherapy for nsclc * concurrent treatment with other experimental drugs, unapproved medical procedures or other anticancer therapy 3. general conditions * pregnant or lactating patients * patients (m/f) with reproductive potential not implementing adequate contraceptive measurements the above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
comparison of a "step-up" versus a "step-down" treatment strategy for patients with new onset dyspepsia in general practice (the diamond-study)

Conditions: Dyspepsia; Gastrointestinal Diseases

Summary: the purpose of this study was to determine which treatment strategy, the step-up or the step-down treatment strategy, is the most cost-effective treatment for patients with new onset dyspepsia in primary care.

dyspepsia is very common in the population. on an annual basis, 20%-40% of the general population suffers from upper gastrointestinal symptoms. the prevalence of dyspepsia presenting in primary care is about 3%, on average 24% of these patients are referred for secondary care in the same year. in spite of consensus statements and guidelines, the most effective treatment strategy for managing dyspepsia in primary care remains to be determined. in 2000 the health council of the netherlands published some advice for the minister of health, welfare and sport with special consideration to the most cost-effective strategies for the management of dyspepsia. the health counsel committee agrees in general with the existing guidelines of the dutch college of general practitioners to start with empirical treatment. however, the committee concluded that more research is necessary for management of dyspepsia in primary care, especially in uninvestigated patients as most research has been conducted in patients with persistent dyspeptic symptoms referred for secondary care. comparison: in this study empirical treatment according to the existing guidelines of the dutch college of general practitioners (the step-up treatment strategy) is compared to a step-down treatment strategy. according to this step-down treatment strategy the patient begins treatment with a proton pomp inhibitor, which is an expensive acid-suppressor and is often prescribed by general practitioners. step-up strategy: algeldrate-magnesium oxide, in case of persisting/relapsing symptoms continued with ranitidine, if necessary continued with pantoprazole. step-down strategy: pantoprazole, in case of persisting or relapsing symptoms continued with ranitidine, if necessary continued with algeldrate-magnesium oxide.

Eligibility criteria:
inclusion criteria: * presence of a new episode of dyspepsia, defined as episodic or persistent symptoms including abdominal pain or discomfort and which are, in the opinion of the general practitioner, referable to the upper gastrointestinal tract. * over 18 years of age * informed consent (written) given. exclusion criteria: * use of prescribed acid suppressive medication during 3 months before consult * investigated by upper gastrointestinal endoscopy one year before inclusion * malignancy * contraindication to the study medication * pregnancy * alarming symptoms like weight loss, bleeding, and disturbed food passage * patients with insufficient comprehension of the dutch language

Keywords: uninvestigated dyspepsia cost effectiveness acid suppressive medicine primary care gastrointestinal complaints gastrointestinal drugs
asthma attack in the emergency department : reasons of this attendance

Conditions: Asthma Attack; Emergency Medicine

Summary: objective: identify modifiable factors that may affect asthma control and the use of emergency room to define customized interventions for the management of asthma prior to emergency room. emergency department attendance is always a sign of poor balance or control of asthma. in spite of a decrease in the number of deaths that has been halved in 20 years and hospitalization due to asthmatic disease, the use of emergency center for this disease has not decreased. we now know that the passage through emergencies and hospitalization for aggravation of asthma is in itself a factor of mortality. acting on the determinants of poor balance or control of asthma is essential to further reduce the mortality and morbidity of asthma.

there is two parts in this study: part 1 - qualitative study by individual interviews until data saturation (although about ten patients should be enough to capture the concepts of interest) on the factors that induce an imbalance of asthma (based on the gina (global initiative for asthma) report whose criteria are validated). an interview guide will be written to systematically address all aspects related to asthma control. in agreement with the patient the interview will be recorded, and the verbatim will be transcribed and coded using a software (nvivo version 10). preparation of a questionnaire a questionnaire will be developed from: * analysis of patient verbatim * other data: gina criteria, psychological criteria (psychological distress is assessed by the 12-item general health questionnaire (ghq-12) which is valid psychometric tools in french) and social criteria. part 2-observational cohort qualitative study. the questionnaire thus prepared will be placed in the patient file upon admission. as soon as possible it will be filled by the patient after improvement of his condition and collected by the doctor or nurse who took care of the patient. to obtain sufficient power to demonstrate significant associations, and assuming that 15 variables are taken into account in a multivariate model and based on the recommendations of 10 subjects per variable, 150 patients are required.

Eligibility criteria:
inclusion criteria: * age\> 18 years * ambulatory patient, visiting one of these centers * diagnosis of asthma already evolving for more than 6 months * prescription of treatment for more than 3 months * patient who can read and write french * agreement for an individual interview (part 1) or fill up a self-questionnaire (part 2) * health insurance coverage exclusion criteria: * patients with other etiology that may explain their dyspnea: heart failure, chronic obstructive pulmonary disease , pneumopathy * patients with a social background that is not compatible with the study: a patient who does not speak french, is homeless or does not have a telephone number * inpatients
correlation between the visual acuity & the oct pattern of macular edema secondary to rvo

Conditions: Retinal Vein Occlusion

Summary: correlation between changes observed in oct and va in patients with retinal vein occlusion whether the patient's va improves when macular edema improves in oct or not ??

central retinal vein occlusion (crvo) is a common retinal vascular disorder. clinically, crvo presents with variable visual loss; fundus may show retinal hemorrhages, dilated tortuous retinal veins, cotton-wool spots, macular edin view of the devastating complications associated with the severe form of crvo, number of classifications were described. all of classifications take into account the area of retinal capillary nonperfusion and development of neovascular complications. crvo can be divided into 2 clinical types, ischemic and nonischemic. in addition, a number of patients may have an intermediate presentation with variable clinical course. on initial presentation, it may be difficult to classify a given patient, since crvo may change with time. a number of clinical and ancillary investigative factors are taken into account for classifying crvo: nonischemic crvo is milder form of disease. it may present with good vision, few retinal hemorrhages and cotton-wool spots, no relative afferent pupillary defect, and good perfusion to the retina. nonischemic crvo may resolve fully with good visual outcome or may progress to the ischemic type. ischemic crvo is the severe form of the disease. crvo may present initially as the ischemic type, or it may progress from nonischemic. usually, ischemic crvo presents with severe visual loss, extensive retinal hemorrhages and cotton-wool spots, presence of relative afferent pupillary defect, poor perfusion to retina, and presence of severe electroretinographic changes. in addition, patients may end up with neovascular glaucoma and a painful blind eye.

Eligibility criteria:
inclusion criteria: * patients with macular edema related to vein occlusion . * patient's age above 18 years old . * patients able to sit on oct device . exclusion criteria: * significant cataract . * media opacities as vitreous haemorrhage . * patients with macular edema related to crvo treated by laser photocoagulation . * patients with glaucoma . * patients with chronic uveitis.
phenylephrine and hypotension during spinal anesthesia for cesarean section

Conditions: Anesthesia, Obstetrical; Anesthesia, Spinal

Summary: pregnant women with a positive preoperative supine stress test were found to be a subgroup at increased risk of symptomatic hypotension after spinal anesthesia

patients will be placed in dorsal decubitus dislocating the uterus to the left for a few minutes, with blood pressure and heart rate recorded three times, with a three-minute interval between measurements to obtain mean baseline levels and this will be repeated in an upright position to record the same measurement.orthostatic hypotension (orthostatic hypotension "oh" is defined specifically as a 20mmhg drop in systolic, and/or a 10mmhg drop in diastolic blood pressure within 3 minutes of standing.

Eligibility criteria:
inclusion criteria: physical status asa i, a full term pregnancy a single fetus elective cesarean section. exclusion criteria: refusal of the patient to participate in the study history of hypertension pregnancy-induced hypertension cardiovascular or cerebrovascular disease fetal abnormalities history of hypersensitivity to the drugs used contraindications to spinal block.

Keywords: orthostatic cesarean section pregnant phenyephrine hypotension